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Abscess? Fistula? Help!

Hello, I just discovered these boards. I spent about 5 hours reading yesterday. Lots of great information. Thanks to those to contribute.

I'm new to Crohn's. My dad has had it for 30 years, so it is something I knew a little about before my problems started. Dad has only had small/large intestine problems, no where else.

They found some minor inflammation in my intestines during a colonoscopy. No pain/issues at all, but doc wanted to start treatment immediately considering my family history. Doc put me on Pentasa, 8 500mg pills/day.

Although I have had no pain or problems with my intestines, i've had some serious problems in my anus area over the past two months. Serious pain. Serious fatigue. Docs put me on Cipro and Flagyl. I was checked a couple times for an abscess, but docs did see/feel anything, but knew something was probably "brewing".

About a week ago I was going to the bathroom. While sitting on the pot, I hear a fizzing noise. I looked down in the toilet, I see this bubbling chemical reaction going on. Something had come out of me that literally was reacting in the water. Then the puss started coming. Now, a week later, I'm having to go to the bathroom about every hour to wipe the puss. What is that? Did I have an abscess that burst? Do I have a fistula?

I've done research on fistulas, but not sure I really understand them. Could an abscess be draining through a fistula? Doc says this is definitely Crohn's related. Is that the case?

During this week of drainage, my fatigue or pain hasn't gotten any better.

My Butt Hurts

Hi terps and welcome.
As I understand it, a fistula is a tunnel that burrows from one place to another. I had a fistula on my butt cheek, right my my anus. It started out as what I would call an abcess cuz it was just a big painful lump. Eventually the surgeon lanced it and then it drained slowly for a year before I ended up needing surgery. Surgery sucked at the time, but now I am not dealing with the fistula so it was worth it.

You might want to go back to the doc now that it has escalated since you were last there. You could also wear a pantiliner to help catch the drainage (even if you're a guy).

Sorry you have to be here, but you have found a great place! Use the 'search' option to find other people's fistula stories.

Another option for dealing with "puss" output is to buy some sterile gauze at the drug store and then fold it in half and kind of stick it up in there. It helps alot and is not as uncomfortable as it sounds.

Also...I definitely encourage another trip to the doctor. If it IS a fistula, they just get harder to treat the longer they go untreated (trust me, I know) and if it is an burst abcess or something, they'll want to check it for infection and that sort of thing.

I think in general...no "output" from that area is normal and it probably warrants a trip no matter what. :)
hey terps-
just like the others said....going back to the doctor is a good idea. they will definitly want to know that something down there is actively draining.

not sure what to make of the fizzing sound, that is really quite strange! i remember the moment one of my fistuals burst through once- i was on the toilet and it made a "PHoooo" noise. like air being let out of a balloon very quietly? but nothing ever fizzing.

ive had quite a few fistulas as well. ill try to explain a bit-
as far as i understand all of it, fistulas can form without the presence of an abcess. ive had a few of those, and its a tract that connects some place in your intestine to any other part of your body. it may pop through in a nearby organ (bladder, for ex) or it may come out on the surface, like the one on our butt cheeks. thats where most of mine have been.
however, when an area of the intestine becomes so severely inflamed, it may form an abcess- a collection of pus and fluids. this abcess wants to drain, but since its deep inside your body, it has to worm its way out, and thus an internal abcess can be the cause of fistulas as well. i has one that wrapped around my colon and sent two fistulas burrowing out my bum cheeks- one for each side, how nice!
i think an indication of whether the fistula is caused by an abcess or not is if you are spiking fevers. a trapped infection in your body will most likely cause a fever until it is draining properly.

so, abcesses and fistulas can be treated with antibiotics- i was put on flagyl and cipro and am still on them. and like MBH said, surgery is also an option. depending on the location and shape of the fistula they can either just open it up so that it will heal from the inside out. or they may (as they did in my case) place things like setons or penrose drains in the tracts to keep it open and draining until it dries up and heals, hopefully with the aid of medication.

erin had a good suggestion with the gauze squares too! i always keep a piece tucked in there in addition to a panty liner. it is so much easier to just throw the soaked gauze in the trash and then tuck in a new one than it is to clean up every 1/2 hour.

also, take warm baths for your bottom. theyre called sitz baths, but really its just a soak in warm water which helps the pus flow and keeps the skin open and clean. you can throw some epsom salts in there if you want. i never have and im honestly not too sure what it does lol! but a number of people do that.

let us know how all goes ok?
and all the things i just said are just what i have gathered over the years of dealing with this. im not really positive about all of the specifics of fistuals and abcesses, its jsut my general understanding, so dont take my word for it all lol!
Thanks for the info guys. It's been really helpful to hear the experiences of others.

I went back to my GI today. He pretty much instantly confirmed I have a fistula.

He couldn't feel an abscess anywhere, but has ordered a CT scan to make sure. He didn't think it was draining puss, rather he called it bodily fluid.

Considering my fistula and other pain in the area, minor inflammation in my colon, and my dad's history with Crohn's, my GI wants to stop the Pentasa and start Remicade. He wants to be aggressive mainly to avoid the two major surgeries my dad has had. He wants to try Remicade for a year, then try something else a little stronger then Pentasa.
glad to hear that he couldnt feel an abcess.
let us know how the ct turns out ok?

and you have some good hope with the remi, there are quite a few of us here who had good experience with it taking care of our fistulas. the years i was on remi was the closest to remission ive ever been!

Glad to hear you have an answer. Fistulas are annoying, but they are treatable. It was after I got my fistulas that I switched to Remicaide, because that is apparently one of the best treatments for them. Unfortunately, it didn't work for me at all....but I think it works for something like 60% of patients.

Good luck :)